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Contractor's Application for PaymentOwner's Project No.:Engineer's Project No.:Agency's Project No.:1 From05/08/23to 05/31/23AC D E F F1 F2 G H I J K LItem Quantity UnitsUnit Price($)Value of Bid Item(C X E)($)Quantity Previous EstimateValue Previous EstimateEstimated Quantity Incorporated in the WorkValue of Work Completed to Date(E X G)($)1 1.00 LS 60,000.00 60,000.00 - 0.25 15,000.00 15,000.00 25% 45,000.00 2 2.00 EACH 1,885.40 3,770.80 - 4.51 8,503.15 8,503.15 225% (4,732.35)3 2.00 EACH 1,604.59 3,209.18 - - - - 3,209.18 4 1.00 EACH 1,504.31 1,504.31 - - - - 1,504.31 5 30.00 LF 29.08 872.40 - - - - 872.40 6 1,512.00 LF 14.54 21,984.48 - 1,686.00 24,514.44 24,514.44 112% (2,529.96)7 57.00 LF 25.07 1,428.99 - 61.00 1,529.27 1,529.27 107% (100.28)8 422.00 LF 2.37 1,000.14 - 411.00 974.07 974.07 97% 26.07 9 300.00 SY 9.61 2,883.00 - - - - 2,883.00 10 120.00 SY 13.78 1,653.60 - 77.00 1,061.06 1,061.06 64% 592.54 11 90.00 SY 22.46 2,021.40 - 122.00 2,740.12 2,740.12 136% (718.72)12 48.00 SF 24.94 1,197.12 - - - - 1,197.12 13 7,210.00 SY 3.00 21,630.00 - - - - 21,630.00 14 578.00 CY 30.00 17,340.00 - - - - 17,340.00 15 396.00 CY 30.00 11,880.00 - 5.50 165.00 165.00 1% 11,715.00 16 94.00 CY 30.00 2,820.00 - - - - 2,820.00 17 35.00 HOUR 160.46 5,616.10 - - - - 5,616.10 18 102.00 MGAL 15.00 1,530.00 - - - - 1,530.00 19 7,207.00 SY 5.00 36,035.00 - - - - 36,035.00 20 1,884.00 SY 3.25 6,123.00 - - - - 6,123.00 21 5,379.00 LF 0.80 4,303.20 - - - - 4,303.20 22 655.00 GAL 2.00 1,310.00 - - - - 1,310.00 23 1,293.00 TON 112.00 144,816.00 - - - - 144,816.00 24 24.00 TON 205.00 4,920.00 - - - - 4,920.00 25 1,291.00 TON 105.00 135,555.00 - - - - 135,555.00 26 1,490.00 LF 29.75 44,327.50 - - - - 44,327.50 27 90.00 SY 95.04 8,553.60 - - - - 8,553.60 28 30.00 SY 137.08 4,112.40 - - - - 4,112.40 29 164.00 LF 12.25 2,009.00 - 164.00 2,009.00 2,009.00 100% - 30 1.00 EACH 531.96 531.96 - 1.00 531.96 531.96 100% - 31 1.00 LS 11,500.00 11,500.00 - 0.34 3,910.00 3,910.00 34% 7,590.00 32 1.00 ALLOW 3,500.00 3,500.00 - - - - 3,500.00 33 1.00 LS 3,000.00 3,000.00 - 0.25 750.00 750.00 25% 2,250.00 34 1.00 LS 1.00 1.00 - - - - 1.00 35 19.00 EACH 260.00 4,940.00 - 15.20 3,952.00 3,952.00 80% 988.00 36 420.00 LF 2.26 949.20 - - - - 949.20 37 80.00 LF 5.52 441.60 - 160.00 883.20 883.20 200% (441.60)38 20.00 CY 154.78 3,095.60 - - - - 3,095.60 39 79.00 CY 72.85 5,755.15 - 70.00 5,099.50 5,099.50 89% 655.65 40 687.00 SY 26.58 18,260.46 - 252.00 6,698.16 6,698.16 37% 11,562.30 41 175.00 SY 3.26 570.50 - - - - 570.50 42 453.00 SY 2.96 1,340.88 - - - - 1,340.88 43 44.00 LF 2.26 99.44 - - - - 99.44 44 22.00 LF 4.51 99.22 - - - - 99.22 608,491.23 - 78,320.93 78,320.93 13% 530,170.30 45 6.00 EACH 300.86 1,805.16 - 8.00 2,406.88 2,406.88 133% (601.72)PART 1: STREETSTOTAL PART 1: STREETSPART 2: SANITARY SEWERContract InformationBid Item No.REMOVE MANHOLEREMOVE PIPE APRONREMOVE BITUMINOUS DRIVEWAY PAVEMENTREMOVE CONCRETE DRIVEWAY PAVEMENTSALVAGE AND REINSTALL DRIVEWAY PAVERSFINISH GRADINGSUBGRADE EXCAVATION (SPOT CORRECTION)REMOVE SEWER PIPE (STORM)REMOVE CURB & GUTTER (SPOT REPAIR)REMOVE EXISTING CORRUGATED METAL PIPEApplication Date:Application Period:Application No.:Engineer:Contractor:Project:Contract:Previous Estimate06/02/23BBASE BID% of Value of Item (J / F)(%)Balance to Finish (F - J)($)MOBILIZATIONCLEARING AND GRUBBINGDescriptionWork CompletedMaterials Currently Stored (not in G)($)Work Completed and Materials Stored to Date (H + I)($)Progress Estimate - Unit Price WorkCity of Little CanadaBolton & Menk, Inc.OMG Midwest, Inc. dba. Minnesota Paving & Materials2023 Street ImprovementsOwner:0N1.12799523-01, 23-02, 23-03, 23-05TYPE SP 12.5 NON WEARING COURSE MIXTURE (3,C)CONCRETE CURB & GUTTER - SURMOUNTABLE (HAND 6" CONCRETE DRIVEWAY PAVEMENT8" CONCRETE VALLEY GUTTERBITUMINOUS CURBSAWCUT BITUMINOUS PAVEMENTREMOVE BITUMINOUS PAVEMENTMILL BITUMINOUS SURFACE (2")JOINT ADHESIVE (MASTIC)BITUMINOUS MATERIAL FOR TACK COATTYPE SP 9.5 WEARING COURSE MIXTURE (3,C)TYPE SP 9.5 WEARING COURSE MIXTURE (2,E), DRIVEWAYSUBGRADE CORRECTION - CLASS 5SELECT GRANULAR BORROW (CV)STREET SWEEPER (WITH PICKUP BROOM)WATERFULL DEPTH RECLAMATIONSTORM DRAIN INLET PROTECTIONSILT FENCE, TYPE MSSEDIMENT CONTROL LOG TYPE STRAWEXCAVATE SEDIMENT AT FESFILTER TOPSOIL BORROW (LV)BITUMINOUS FLUMETRAFFIC CONTROLRAILROAD FLAGGINGEROSION CONTROL SUPERVISORSTABILIZED CONSTRUCTION EXITREMOVE FRAME AND RING CASTING (SANITARY)SODDING TYPE LAWNBLANKET CATEGORY 20, SEED MIX 35-241FLEXTERRA HYDROMULCH, SEED MIX 25-151, FERTILIZER4" SOLID LINE PAINT4" DOUBLE SOLID LINE PAINTUnit PriceEJCDC C-620 Contractor's Application for Payment(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.1 of 2DocuSign Envelope ID: BEACCBB5-318D-49AD-AE23-8A03627904F8
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